TY - JOUR
T1 - Patients with locally advanced and metastatic cutaneous squamous cell carcinoma treated with immunotherapy in the era of COVID-19: stop or go? Data from five Italian referral cancer centers
T2 - Therapeutic Advances in Medical Oncology
AU - Saponara, M.
AU - Pala, L.
AU - Conforti, F.
AU - Rubatto, M.
AU - De Risi, I.
AU - Spagnolo, F.
AU - Guida, M.
AU - Bossi, P.
AU - Quaglino, P.
AU - Queirolo, P.
N1 - Export Date: 5 March 2021
Correspondence Address: Saponara, M.; Division of Medical Oncology for Melanoma, Italy; email: maristella.saponara@ieo.it
References: COVID-19 - situazione nel mondo, , http://www.salute.gov.it, accessed 1 August 2020; Dai, M., Liu, D., Liu, M., Patients with cancer appear more vulnerable to SARS-CoV-2: a multicenter study during the COVID-19 outbreak (2020) Cancer Discov, 10, pp. 783-791; Liang, W., Guan, W., Chen, R., Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China (2020) Lancet Oncol, 21, pp. 335-337; Yu, J., Ouyang, W., Chua, M.L.K., SARS-CoV-2 transmission in patients with cancer at a tertiary care hospital in Wuhan, China JAMA Oncol, , Epub ahead of print 25 March 2020; Lee, L.Y.W., Cazier, J.B., Starkey, T., COVID-19 mortality in patients with cancer on chemotherapy or other anticancer treatments: a prospective cohort study Lancet, , Epub ahead of print 28 May 2020; Tian, J., Yuan, X., Xiao, J., Clinical characteristics and risk factors associated with COVID-19 disease severity in patients with cancer in Wuhan, China: a multicentre, retrospective, cohort study Lancet Oncol, , Epub ahead of print 29 May 2020; https://clinicaltrials.gov/ct2/show/NCT03666325; I numeri del cancro in Italia 2018: incidenza, mortalità e sopravvivenza per tumore in Italia, , https://www.aiom.it/wp-content/uploads/2018/08/20180927RM_01_Gori.pdf; Bersanelli, M., Controversies about COVID-19 and anticancer treatment with immune checkpoint inhibitors (2020) Immunotherapy, 12, pp. 269-273; Warner, J.L., Rubinstein, S., Grivas, P., Clinical impact of COVID-19 on patients with cancer: Data from the COVID-19 and Cancer Consortium (CCC19), , Presented at American Society of Clinical Oncology (ASCO): cancer care the time of COVID: assessing impact and future directions, 29–31 May 2020, Abstract LBA110; Horn, L., Whisenant, J.G., Torri, V., (2020) Thoracic Cancers International COVID-19 Collaboration (TERAVOLT): impact of type of cancer therapy and COVID therapy on survival, , Presented at American Society of Clinical Oncology (ASCO). Cancer care the time of COVID: assessing impact and future directions, Abstract LBA111; Kuderer, N.M., Choueiri, T.K., Shah, D.P., COVID-19 and Cancer Consortium. Clinical impact of COVID-19 on patients with cancer (CCC19): a cohort study (2020) Lancet, 395, pp. 1907-1918; Luo, J., Rizvi, H., Egger, J.V., Impact of PD-1 blockade on severity of COVID-19 in patients with lung cancers Cancer Discov, , Epub ahead of print 12 May 2020; Garassino, M.C., Whisenant, J.G., Huang, L.C., TERAVOLT investigators. COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study (2020) Lancet Oncol, 21, pp. 914-922; Robert, C., Ribas, A., Hamid, O., Durable complete response after discontinuation of pembrolizumab in patients with metastatic melanoma (2018) J Clin Oncol, 36, pp. 1668-1674
PY - 2020
Y1 - 2020
N2 - Since the end of 2019, global healthcare systems have been dealing with the COVID-19 pandemic. In oncology, the biggest questions concern interaction of COVID-19 with pre-existing cancer disease and with systemic anticancer treatments. With regards to immunotherapy, there is uncertainty about its effect in the context of COVID-19 in terms of probability and course of viral infection. Herein, we retrospectively report data of patients with advanced cutaneous squamous cell carcinoma (cSCC) treated with immunotherapy at five Italian referral cancer centers during the pandemic. cSCC is a disease poorly represented in the literature, typically affecting fragile, elderly patients, with multiple comorbidities and often immunosuppressed. Overall, 54 patients were identified, most of them coming from Lombardy and Piedmont, the two regions hit hardest by COVID in Italy. In most cases, our choice was to continue treatment, reserving temporary interruptions only to patients considered particularly at risk for age and comorbidity. A total of 9% of patients developed new-onset symptoms or had chest radiological assessment potentially related to COVID-19. Nasopharyngeal swabs were collected in all suspicious cases and two hospitalized patients were found to be positive. In conclusion, the outbreak of COVID-19 is a major worldwide health concern. Our data indicate that COVID-19 mortality in patients with cancer may be principally driven by advancing age, the presence of other comorbidities, and other cancer-related conditions (i.e. hospitalization). Our data further suggests the safety of continued use of PD-1 blockade during the COVID-19 pandemic (obviously implementing all the safety measures in the hospital environment) also considering the possible negative effects of a prolonged suspension on the course of the tumor evolution. We think it is useful to collect and report case studies coming from reference centers, because they can represent helpful examples for the scientific community of clinical management of patients affected by cancer in this difficult period and guide further research. © The Author(s), 2020.
AB - Since the end of 2019, global healthcare systems have been dealing with the COVID-19 pandemic. In oncology, the biggest questions concern interaction of COVID-19 with pre-existing cancer disease and with systemic anticancer treatments. With regards to immunotherapy, there is uncertainty about its effect in the context of COVID-19 in terms of probability and course of viral infection. Herein, we retrospectively report data of patients with advanced cutaneous squamous cell carcinoma (cSCC) treated with immunotherapy at five Italian referral cancer centers during the pandemic. cSCC is a disease poorly represented in the literature, typically affecting fragile, elderly patients, with multiple comorbidities and often immunosuppressed. Overall, 54 patients were identified, most of them coming from Lombardy and Piedmont, the two regions hit hardest by COVID in Italy. In most cases, our choice was to continue treatment, reserving temporary interruptions only to patients considered particularly at risk for age and comorbidity. A total of 9% of patients developed new-onset symptoms or had chest radiological assessment potentially related to COVID-19. Nasopharyngeal swabs were collected in all suspicious cases and two hospitalized patients were found to be positive. In conclusion, the outbreak of COVID-19 is a major worldwide health concern. Our data indicate that COVID-19 mortality in patients with cancer may be principally driven by advancing age, the presence of other comorbidities, and other cancer-related conditions (i.e. hospitalization). Our data further suggests the safety of continued use of PD-1 blockade during the COVID-19 pandemic (obviously implementing all the safety measures in the hospital environment) also considering the possible negative effects of a prolonged suspension on the course of the tumor evolution. We think it is useful to collect and report case studies coming from reference centers, because they can represent helpful examples for the scientific community of clinical management of patients affected by cancer in this difficult period and guide further research. © The Author(s), 2020.
KW - Anti-PD-1
KW - COVID-19
KW - cSCC
KW - cutaneous squamous cell carcinoma
KW - immunotherapy
U2 - 10.1177/1758835920977002
DO - 10.1177/1758835920977002
M3 - Article
VL - 12
JO - Ther. Adv. Med. Oncol.
JF - Ther. Adv. Med. Oncol.
SN - 1758-8340
ER -